Placebo's power goes beyond the mind

Brain waves may hold key
At the University of California at Los Angeles, placebo-treated volunteers were hooked up to an electroencephalograph (EEG), a device that records the brain’s electrical activity. After a week of sugar pills, the volunteers were then given either more placebos or an actual antidepressant. They weren’t told which type of pill they received.

Eight weeks later, researchers scrutinized the brain waves recorded by the EEG back when all the volunteers were taking placebos. The UCLA scientists discovered something intriguing: The people who got the most benefit from the actual medication had a specific pattern of brain waves when they were being treated with placebos.

Those results were described in a study published this month in the American Journal of Psychiatry. Researchers haven’t figured out yet what the specific pattern of brain waves mean, but the study does show how patients might be inexpensively screened with an EEG to show doctors who is most likely to respond to antidepressant medications, says the report’s lead author Aimee M. Hunter, a research associate at the Semel Institute for Neuroscience and Human Behavior at UCLA.

Teaching patients to soothe themselves
Meanwhile, at Stanford University, scientists figured there must be a way to harness the placebo response to help patients soothe their own pain. 

The researchers rigged up an MRI so that people could watch real-time images of their brains, while lying in the scanner. The idea was to use the images to teach study volunteers to consciously pump up activity in parts of the brain activated by the placebo effect, says Dr. Sean Mackey, associate director of Stanford’s pain management division and director of its neuroimaging and pain lab.

One of those volunteers, Laura Tibbitts, signed up for the study in hopes that she might be able to find a way to quiet the constant, permanent pain that descended after her right shoulder and arm were smashed in a riding accident eight years earlier.

“Pain is not in the muscles or the arm that may be injured,” Mackey says. “The pain is in our brains.”

A signal starts out at an injured site and travels up to the brain, Mackey explains. But, until the brain interprets that electrical signal, you don’t actually “feel” pain.

Part of what goes into the brain’s interpretation is expectation, Mackey says. “I think of the placebo response, at least in part, as a manipulation of expectancy. And perhaps by changing the expectancy and bumping up the placebo response we might be able to ultimately find a way to provide sustained therapy for chronic pain.”

Lying back in the scanner watching images of her brain, Tibbitts was told to conjure up memories of her pain on the day of the accident. Later, she was instructed to think soothing thoughts. “I imagined little people scooping away the pain, trying to rescue me,” the 32-year-old San Francisco resident says. “Or I thought about water or snowflakes putting the fire out.”

Empowering experiment
Through trial and error, Tibbitts determined which kinds of thoughts fired up and turned down the brain regions that Mackey said were linked to her pain. The mental pictures had an impact.

And the newfound control over pain levels was empowering, Tibbitts says.

“I think the most incredible thing was to see that scan of my brain constantly producing pain,” she adds. “And then to actually gain control over the pain, to see that I had that power — even when I was making myself feel worse — was amazing to me.”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and Smart Money.

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